摘要
目的分析不同胎龄新生儿出生后凝血功能及血小板,为新生儿诊治及出血倾向评估提供依据。方法选取蚌埠医学院第二附属医院儿科2019年10月—2022年4月收治的新生儿89例,依据胎龄分组,早期早产儿(胎龄28~31^(+6)周)11例,中期早产儿(胎龄32~33^(+6)周)17例,晚期早产儿(胎龄34~36^(+6)周)26例,足月儿(胎龄37~41^(+6)周)35例。所有患儿入院6 h内检测血小板(PLT)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)及国际标准化比值(INR);比较4组患儿临床资料、检测指标、凝血功能异常发生率及出血发生率;比较早产儿及足月儿新生儿弥散性血管内凝血(DIC)发生率。结果早期及中期早产儿血清PT、APTT、TT、D-D和INR均高于晚期早产儿及足月儿;血清FIB低于晚期早产儿及足月儿;早期早产儿PLT低于其他三组(均P<0.05);早期、中期、晚期早产儿及足月儿出血发生率分别为72.73%(8/11)、52.94%(9/17)、30.77%(8/26)、25.71%(9/35),凝血功能异常发生率分别为81.82%(9/11)、70.59%(12/17)、53.85%(14/26)、37.14%(13/35),早期及中期早产儿出血发生率和凝血功能异常发生率均高于晚期早产儿及足月儿;早产儿DIC发生率为22.22%(12/54),高于足月儿的2.86%(1/35)。结论胎龄越小,新生儿凝血功能越差,出血发生率、凝血功能异常发生率及DIC发生率越高。
Objective To explore the coagulation function and platelets of neonates of different gestational ages after birth,and to provide a basis for the diagnosis and treatment of neonates and the evaluation of bleeding tendency.Methods A total of 89 neonates admitted to the Department of Pediatrics of the Second Affiliated Hospital of Bengbu Medical College from October 2019 to April 2022 were selected.Based on the gestational age,there were 11 cases of early preterm infants(28-31^(+6)weeks),17 cases of moderately preterm infants(32-33 weeks)and 26 cases of late preterm infants(34-36 weeks).Meanwhile,there were a total of 35 full-term infants(gestational age 37-41^(+6)weeks).The platelet(PLT),prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer(D-D)and international normalized ratio(INR)were measured within 6 hours after admission.In addition,the clinical data,detection indicators,incidence of abnormal coagulation function and incidence of bleeding were compared among the four groups to compare the incidence of disseminated intravascular coagulation(DIC)in preterm infants and full-term infants.Results Serum PT,APTT,TT,D-D and INR of early and moderately preterm infants were higher than those of late preterm infants and full-term infants,and the serum FIB was lower than that of late preterm and full-term infants.Meanwhile,PLT in early preterm infants was lower than that in the other three groups(all P<0.05).The incidence of bleeding in early,middle,late preterm and full-term infants were 72.73%(8/11),52.94%(9/17),30.77%(8/26)and 25.71%(9/35),respectively.Moreover,the incidences of abnormal coagulation function were 81.82%(9/11),70.59%(12/17),53.85%(14/26)and 37.14%(13/35),respectively.Furthermore,the incidences of bleeding and abnormal coagulation function in early and moderately preterm infants were higher than those in late preterm infants and full-term infants.The incidence of DIC in preterm infants was 22.22%(12/54),which was higher than that in full-term infants at 2.86%(1/35).Conclusion The lower the gestational age,the more imperfect the coagulation function,and the higher the incidence of bleeding,coagulation dysfunction and DIC.
作者
贾文婷
汪灵芝
刘敏敏
张阵
JIA Wen-ting;WANG Ling-zhi;LIU Min-min;ZHANG Zhen(Department of Pediatrics,the Second Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233040,China;不详)
出处
《中华全科医学》
2022年第11期1878-1880,1908,共4页
Chinese Journal of General Practice
基金
安徽高校自然科学研究重点项目(KJ2021A0800)
蚌埠医学院自然科学重点项目(BYKY2019155ZD)。
关键词
早期早产儿
中期早产儿
晚期早产儿
足月儿
凝血功能
血小板
弥散性血管内凝血
Early preterm infant
Moderate preterm infant
Late preterm infant
Full-term infant
Coagulation function
Blood platelet
Disseminated intravascular coagulation
